Cancer has surpassed heart disease as the leading cause of death in California and 21 other states, according to a new report from the Centers for Disease Control and Prevention.

That total is in stark contrast to the situation at the start of this century, when only two states — Alaska and Minnesota — lost more people to cancer than heart disease.

And it’s a huge departure from the situation in the 1950s, when the number of heart disease deaths was 2½ times bigger than the number of cancer fatalities.

Nationwide, heart disease still edges out cancer as the top killer of Americans. In 2014, 614,348 U.S. residents died of heart disease, compared with 591,699 who succumbed to cancer, according to the CDC tally of death certificates from the 50 states and the District of Columbia.